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Feel Better Now!

Effective and safe solutions to chronic health conditions are frequently sought after, but hard to come by. On a recent fact finding mission, I uncovered five natural options that fit this description. If you or anyone you know is living with lower back pain, depression, menopausal symptoms, post-traumatic stress disorder or work related “burnout”, take special notice of the following research.

The latest edition of the journal Arthritis Care & Research reports that practicing Tai Chi for 10 weeks “improved pain and disability outcomes and can be considered a safe and effective intervention for those experiencing long-term low back pain symptoms”. Reiki, a form of energy healing, was recently shown to limit some of the damaging manifestations of “burnout syndrome”. In a double-blind study, nurses were administered one session of reiki or “sham reiki”. Those receiving authentic reiki exhibited a reduction in blood pressure and increased secretory immunoglobulin or sIgA – a measure of robust immune function. New data appearing in the Journal of Affective Disorders offers hope for women living with chronic depression. According to an analysis of over 2,100 adult females, low zinc status was associated with depressive symptoms. What’s more, supplemental zinc is mentioned as a helpful adjunct to antidepressant therapy in women. Those suffering from post-traumatic stress disorder (PTSD) may likewise have a new treatment option available to them. Xiao-Tan-Jie-Yu-Fang, a traditional Chinese herbal formula, recently demonstrated both efficacy and a lack of toxicity in a controlled trial involving 225 patients with PTSD.

Finally, new evidence presented in the October 24th issue of the journal Menopause supports the use of red ginseng (3 grams/day) to counter menopausal symptoms. But, the study in question goes on to describe several other important findings. In addition to improvements in a “menopausal rating scale”, the researchers observed positive changes in various cardiovascular risk factors. In particular, a decline in carotid intima-media thickness and LDL (“bad”) cholesterol were singled out. It’s also important to note that ginseng did not alter serum estrogen levels, which is always a consideration when evaluating drugs and supplements that address hormonal symptoms.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 -Tai Chi Exercise for Treatment of Pain and Disability in People …(link)

26 Comments & Updates to “Feel Better Now!”

Well, as you know, JP, the skeptic in me sometimes like to interject – and I was just going to post a link to a 2011 review about reiki that basically concludes that it “does not allow conclusions regarding the efficacy or effectiveness of energy healing.”

I suspect that having one-on-one interaction with nurses for any kind of therapy would probably be better than no interaction whatsoever. Maybe just having someone to talk to will make a patient feel better?

As always, I appreciate hearing and considering your point of view. Here are a few of my thoughts about this issue:

The same review you cited also states, “Future studies should adhere to existing standards of research on the efficacy and effectiveness of a treatment …”

I believe the authors of the reiki study I referenced attempted and succeeded in designing a trial with reasonable controls. They used both (authentic) reiki and sham reiki as a placebo in the research.

“The study was randomized, double-blind, placebo-controlled, using a crossover design, and conducted to compare the immediate effects of Reiki versus placebo (sham Reiki) in nurses with BS. Potential participants were screened for eligibility and introduced to the study. After completing informed consent forms, a brief demographic form from the participants was taken. Neither the participants nor the data collectors knew which participants were in which group. Participants arrived at the laboratory at between 9-12 am in two separate occasions to avoid circadian rhythm-induced variations. Treatment sessions were carried at one week intervals. Participants were instructed not to take any anxiolytic or analgesic drug for approximately 48 hours prior to the experimental session. Participants were also requested to abstain from caffeine, alcohol, food and exercise for 2h prior to taking part in the study to reduce the influence of these substances on saliva measurements. In the first session, all participants rested in a supine position for 20 minutes. Baseline measurements of blood pressure (in triplicate) were then taken and a stimulated saliva sample (3 min) was collected. Immediately after collection, saliva samples were centrifuged at 3000 rpm for 15min to remove any sediment and were stored at -70º C until analysis.

Participants were then randomly assigned to either the Reiki treatment or placebo group using the face of a coin method. The intervention and placebo were carried out as previously described(13). Briefly, the Reiki treatment was administered by the same therapist with more than 15 years of clinical experience in Usui Reiki (Level 3). Participants were fully clothed and the Reiki practitioner placed their hands over various parts of the body (without touching), for approximately 5 minutes before changing hand positions. Areas treated were primarily around the head, eyes, ears and chest and the treatment lasted for a total of 30 minutes. The placebo intervention was administered by a nurse without experience in Reiki but mimicking the Reiki intervention as much as possible e.g using the same hand positions for approximately 5 minutes. The nurse focused attention in neutral stimulus with no healing intentions during the placebo session. The placebo intervention hast the same duration that experimental session.

Immediately following the intervention, post-treatment saliva samples and BP measurements (in triplicate) were taken. As before, the salivary samples were centrifuged at 3000rpm for 15min to remove any sediment and were stored at -70ºC until further analysis. All salivary samples and BP measurements were performed by an assessor blinded to the treatment allocation of the participants.”

I agree that being in the presence of a compassionate healer and/or experiencing physical contact can benefit patients in and of itself. However, in this case, it appears that there was a positive affect attributable to reiki that went above and beyond compassion and/or human touch.

Hey JP,
nice little post. I just wanted to agree with you on your first poitn. I work with many people suffering arthritis and Tai-Chi in combination with water based therapies have been by far the most enjoyable and symptom relieving, wholistic approach to manageing arthritis.

If only people knew how cheap and easy starting your day with a swim and some tai-chi is AND how effective it is on joint management there would be a lot more happy chappys.
Olly.

Previous research has documented the beneficial effect of Tai Chi, but most of the studies focused on elders and patients with specific health conditions. The aim of the study was to test whether Tai Chi can help to improve self-concept in adolescents with a longitudinal study. The sample comprised 160 students from a Chinese middle school; half of students formed the experimental group and the rest formed the control group. A 1-year Tai Chi intervention was delivered in 60-minute sessions, five times a week. Both groups were instructed to complete the measure of self-concept at the beginning and end of the intervention. Statistical analysis shows the significant reduction of good behaviour, intellectual and school status, popularity and anxiety in the experimental group compared with the control group. The results suggest that the Tai Chi intervention could improve self-concept in adolescents.

INTRODUCTION: Demographic facts and forecasts about lengthening life expectancy motivate to systematize the knowledge of health problems experienced by women at the age of 50 and older. It refers to the whole health policy including health economics. Longer female life spans cause that an increasing number of women suffer from health problems associated with the perimenopausal period, and become health care recipients. Also a shift of retirement age is the reason to take interdisciplinary actions for women’s health and quality of life. This study describes a decline in the levels of many bioelements in hair, urine and blood serum, which progresses with age. It not only correlates with a decrease in the synthesis and secretion of estrogen, but also environmental pollution, unhealthy lifestyle and the use of substances.

AIM OF THE STUDY: The aim of this study was to determine the correlation between serum zinc levels in postmenopausal women and such variables as the use of substances (cigarettes, alcohol) and menopausal hormone therapy (MHT). Material and method: The study was conducted among 152 healthy women being 1-16 years after menopause. The women were divided into study group (MHT users) and control group (MHT non-users). A sub-division criterion was the use of substances (cigarettes, alcohol). Serum zinc levels were determined in all women. Results: The use of substances significantly contributed to the lowering of serum zinc levels in postmenopausal women. MHT users had statistically higher average zinc levels in blood serum, which referred both to smokers and consumers of alcohol and those who did not use these substances.

“Conclusions: Nursing home residents seem at risk of marginal Zn status, which correlates with their mental status as measured by the AMTS and GDS. Their low FS is associated with mental health deterioration and obesity.”

The aim of this study was to investigate the effect of Reiki on pain, anxiety, and hemodynamic parameters on postoperative days 1 and 2 in patients who had undergone cesarean delivery. The design of this study was a randomized, controlled clinical trial. The study took place between February and July 2011 in the Obstetrical Unit at Odemis Public Hospital in Izmir, Turkey. Ninety patients equalized by age and number of births were randomly assigned to either a Reiki group or a control group (a rest without treatment). Treatment applied to both groups in the first 24 and 48 hours after delivery for a total of 30 minutes to 10 identified regions of the body for 3 minutes each. Reiki was applied for 2 days once a day (in the first 24 and 48 hours) within 4-8 hours of the administration of standard analgesic, which was administered intravenously by a nurse. A visual analog scale and the State Anxiety Inventory were used to measure pain and anxiety. Hemodynamic parameters, including blood pressure (systolic and diastolic), pulse and breathing rates, and analgesic requirements also were recorded. Statistically significant differences in pain intensity (p = .000), anxiety value (p = .000), and breathing rate (p = .000) measured over time were found between the two groups. There was a statistically significant difference between the two groups in the time (p = .000) and number (p = .000) of analgesics needed after Reiki application and a rest without treatment. Results showed that Reiki application reduced the intensity of pain, the value of anxiety, and the breathing rate, as well as the need for and number of analgesics. However, it did not affect blood pressure or pulse rate. Reiki application as a nursing intervention is recommended as a pain and anxiety-relieving method in women after cesarean delivery.

Effect of Eye Movement Desensitization and Reprocessing (EMDR) on Depression in Patients With Myocardial Infarction (MI).

BACKGROUND: Coronary heart disease is the most important cause of death and inability in all communities. Depressive symptoms are frequent among post-myocardial infarction (MI) patients and may cause negative effects on cardiac prognosis. This study was conducted to identify efficacy of EMDR on depression of patients with MI.

METHODS: This study is a clinical trial. Sixty patients with MI were selected by simple sampling, and were separated randomly into experimental and control groups. To collect data, demographic questionnaire and Beck Depression Questionnaire were used. In experimental group, EMDR therapy were performed in three sessions alternate days for 45-90 minutes, during four months after their MI. Depression level of patients was measured before, and a week after EMDR therapy. Data were analyzed using paired -t- test, t-test, and Chi-square.

RESULTS: The mean depression level in experimental group 27.26± 6.41 before intervention, and it was 11.76 ± 3.71 after intervention. Hence, it showed a statistically significant difference (P<0.001). The mean depression level in control group was 24.53 ± 5.81 before intervention, and it was 31.66± 6.09 after intervention, so it showed statistically significant difference (P<0.001). The comparison of mean depression level at post treatment, in both groups showed statistically significant difference (P<0.001).

CONCLUSION: EMDR is an effective, useful, efficient, and non-invasive method for treatment and reducing depression in patients with MI.

Evaluation of Tai Chi Program Effectiveness for People with Arthritis in the Community: A Randomized Controlled Trial.

OBJECTIVE: Evaluate effectiveness of the Arthritis Foundation Tai Chi program for community participants with arthritis.

METHODS: 343 individuals were randomized to intervention or wait-list control. Performance and self-reported outcome (SRO) measures were assessed at baseline and 8 weeks. At 1 year, SROs only were assessed. Adjusted means were determined using regression models adjusting for covariates and effect sizes (ES) calculated.

RESULTS: Average participant age was 66 years, 87% were female and 87% Caucasian. Among 284 (83%) participants who returned at 8 weeks, balance by reach (ES=0.30) and helplessness, sleep, and role participation satisfaction (ES=0.24-0.54) improved significantly; pain, fatigue and stiffness improvement (ES=0.15-0.23) approached significance. No change was noted in mobility, lower-extremity strength, or single leg stance balance. At 1-year, improvements in pain, fatigue, stiffness, helplessness and role participation satisfaction at 8 weeks were maintained; 30% continued tai chi practice.

CONCLUSION: Moderate effectiveness of the AF Tai Chi Program was confirmed.

The Impact of Tai Chi Exercise on Self-Efficacy, Social Support, and Empowerment in Heart Failure: Insights from a Qualitative Sub-Study from a Randomized Controlled Trial.

OBJECTIVE: To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF).

SUBJECTS AND METHODS: We randomized 100 patients with chronic systolic HF (NYHA Class 1-3, ejection fraction≤40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States).

RESULTS: The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient’s experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility).

CONCLUSION: Positive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.

Emerging evidence suggests a positive association of diet and obesity with depression. Researchers have examined several diet-mood hypotheses, including investigating the extent to which carbohydrates may impact mood. There is limited research on how glycemic load, a characteristic of carbohydrates, impacts mood in healthy adults. Eighty-two healthy weight and overweight/obese, but otherwise healthy, adults enrolled in a randomized, crossover controlled feeding study testing low-compared to high-glycemic load diets. All participants completed self-report mood and energy level questionnaires during each arm of the intervention. Diets were isocaloric and were matched by macronutrient content as a percent of total energy. Mood was assessed with the Profile of Mood States (POMS) subscales; tension-anxiety, depression-dejection, anger-hostility, vigor-activity, fatigue-inertia, and confusion-bewilderment, total mood disturbance (TMD), and negative affect (NA) in addition to the Center for Epidemiological Studies – Depression (CES-D) scale at baseline and end of both 28-day feeding periods. Linear mixed models tested the intervention effect on mood, controlling for baseline POMS and CES-D scores, diet type, diet sequence, feeding period, sex, and percent body fat classification. The consumption of the high-glycemic load diet resulted in a 38% higher score for depressive symptoms on the CES-D (P = 0.002) compared to the low-glycemic load diet as well as 55% higher score for TMD (P = 0.05), and 26% higher score for fatigue/inertia (P = 0.04). In subgroup analyses, the overweight/obese participants had 40% higher scores on the CES-D scale compared to healthy weight participants (P = 0.05). In conclusion, a high-glycemic load diet was associated with higher depression symptoms, total mood disturbance, and fatigue compared to a low-glycemic load diet especially in overweight/obese, but otherwise healthy, adults.

Seated T’ai Chi in Older Taiwanese People Using Wheelchairs: A Randomized Controlled Trial Investigating Mood States and Self-Efficacy.

OBJECTIVE: There is growing interest in t’ai chi, but little research has addressed whether t’ai chi is effective in older people using wheelchairs for mobilization. The aim of this study was to compare the effects of seated t’ai chi exercise and usual standard activities on mood states and self-efficacy in older people living in a long-term care facility and using wheelchairs for mobilization.

Association between frequency of fried food consumption and resilience to depression in Japanese company workers: a cross-sectional study

Background: Long-chain n-3 and n-6 polyunsaturated fatty acids (LC n-3/n-6 PUFA) play important roles in emotional regulation. We previously reported an association between fish consumption, which is major source of LC n-3 PUFA, and resilience to depression, where resilience is the ability to cope with stress in the face of adversity. Although the traditional Japanese dietary pattern of high fish consumption is associated with low depressive symptoms, the current Japanese diet pattern has become westernized. Westernized diets contain excessive amounts of LC n-6 PUFA due to high intake of vegetable oils commonly used in fried food and are associated with risk of depression. The aim of this study was to examine the association between frequency of fried food consumption and resilience to depression.

Methods: Participants were 715 Japanese company workers. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms, and the 14-item Resilience Scale (RS-14) was used to measure resilience. Frequency of fish and fried food consumption was assessed using a self-report questionnaire based on the Food Frequency Questionnaire. Regression analyses using Preacher and Hayes’ bootstrap script were used to adjust for demographic factors, frequency of physical exercise, and fish consumption.

Conclusion: Frequency of fried food consumption was associated with lower resilience to depression. Further nutritional interventional studies to increase resilience and prevent depression are warranted.

The Effects of Tai Chi on Sleep Quality in Chinese American Patients With Major Depressive Disorder: A Pilot Study.

OBJECTIVE: This pilot study evaluated the effects of Tai Chi training on sleep quality (primary outcomes), and depression and social functioning levels (secondary outcomes) among patients with depression.

CONCLUSION: This study contributes important insights into the potential benefits and mechanisms of TC and, with further research, may ultimately lead to effective strategies for reducing CVD risk in women earlier in the CVD trajectory.

METHODS: This was an assessor blinded, randomized feasibility trial, and participants were randomized into one of three groups: 10 weeks of TCC meeting 2 times per week, 10 weeks of TCC with a DVD of the curriculum, and control group receiving a handout on anxiety management. Anxiety and sleep quality were assessed 4 times: baseline, 4 weeks, 10 weeks (immediate post-intervention), and 2 months post-intervention. Retention was defined as a participant attending the baseline assessment and at least one other assessment. Adherence to the intervention was set a priori as attendance at 80% of the TCC classes.

RESULTS: Eighty-five percent of participants were retained during the intervention and 70% completed the 2 month follow-up assessments. To increase statistical power, the two TCC groups were combined in the analyses of anxiety and sleep quality measures. No significant changes in anxiety were found in the control group, while levels of anxiety decreased significantly over time in the two TCC groups. Sleep quality scores improved across time for all three groups, but adherent TCC participants reported greater improvement than control participants.

CONCLUSION: TCC may be an effective nonpharmaceutical means of improving anxiety and poor sleep quality in young adults.

Background. The present study aimed to evaluate and compare the effect of two different types of Tai Chi programs on the Functional Movement Screening (FMS) in older adults. Methods. Ninety older adults (65.5 ± 4.6 years old) who met the eligibility criteria were randomized into three different groups based on a ratio of 1 : 1 : 1: a traditional Tai Chi exercise (TTC), a simplified Tai Chi exercise (TCRT), or a control group (routine activity). The FMS consisted of the deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg rise, trunk stability push-up, and rotatory stability, which was used to measure physical function before the present study and after six months of Tai Chi interventions. Results. Seventy-nine participants completed the present study (control = 27, TTC = 23, and TCRT = 29). Significant improvement on the FMS tests between the baseline and after the six-month intervention was observed in both Tai Chi programs, whereas no significant improvement was observed in the control group. In addition, participants in the TCRT group demonstrated greater improvement than those in the TTC group. Conclusions. The TCRT is more effective in improving the physical function in older adults when compared to the traditional Tai Chi modality, particularly for improving balance.

A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners.

INTRODUCTION: Stress and burnout are highly prevalent among medical doctors, and are associated with negative consequences for doctors, patients, and organizations. The purpose of the current study was to examine the effectiveness of a mindfulness training intervention in reducing stress and burnout among medical practitioners, by means of a Randomised Controlled Trial design.

METHODS: Participants were 44 intern doctors completing an emergency department rotation in a major Australian hospital. Participants were randomly assigned to either an active control (one hour extra break per week) or the 10-week mindfulness training intervention. Measures of stress and burnout were taken pre-, mid- and post intervention.

RESULTS: Participants undergoing the 10-week mindfulness training program reported greater improvements in stress and burnout relative to participants in the control condition. Significant reduction in stress and burnout was observed for participants in the mindfulness condition. No such reductions were observed for participants in the control condition.

CONCLUSIONS: Mindfulness interventions may provide medical practitioners with skills to effectively manage stress and burnout, thereby reducing their experience of these symptoms. It is likely that doctors would benefit from the inclusion of such a training program as a part of their general medical education.

Emulsified omega-3 fatty-acids modulate the symptoms of depressive disorder in children and adolescents: a pilot study.

BACKGROUND: The prevalence of mood disorders in children is a growing global concern. Omega-3 fatty acids (FA) are emerging as a promising adjuvant therapy for depressive disorder (DD) in paediatric patients. The primary objective of this pilot, single-centre, randomized, double-blind controlled study was to compare the efficacy of an Omega-3 FA fish oil emulsion with a control oil emulsion alongside standard treatment for depressive symptoms in children and adolescents suffering from depressive disorder (DD) and mixed anxiety depressive disorder (MADD).

METHODS: 38 children (12 patients were treated and diagnosed for at least 1 month before enrolment, 26 patients were first-time diagnosed as DD) aged 11-17 years were randomised 1:1 to the intervention (Omega-3 FA, 19 patients) or active comparator (Omega-6 FA, 19 patients) groups. Children’s depression inventory (CDI) ratings were performed at baseline, every 2 weeks for a 12-week intervention period and at 4-week post-intervention. 35 patients (17 in Omega-3 and 18 in Omega-6 groups) who completed the whole intervention period were evaluated. Patients from Omega-3 group were stratified according to diagnosis into two subgroups (DD-10/17 and mixed anxiety depressive disorder (MADD)-7/17 patients) and in the Omega-6 group into DD-10/18 and MADD-8/18 patients. Groups were evaluated separately. Differences between-groups were tested with the Student´s t test or non-parametric Mann-Whitney U test. Two-way ANOVA with repeated measures and Friedman test were used to analyse the Treatment effect for response in CDI score. p < 0.05 was considered significant in all statistical analyses.

CONCLUSIONS: CDI scores were reduced in the Omega-3 group and the depression subgroup had greater improvement than the mixed depressive/anxiety group. An Omega-3 fatty acid rich fish oil emulsion may be an effective adjuvant supplement during the treatment of depressive disorders in children.

Mediterranean-type diet is associated with higher psychological resilience in a general adult population: findings from the Moli-sani study.

BACKGROUND/OBJECTIVE: Psychological resilience is a measure of stress coping ability and has been associated with favourable health outcomes. While evidence on the relationship of dietary habits with a number of psychosocial conditions is available, there is lack of studies on their association with psychological resilience in a general adult population.

SUBJECTS/METHODS: Cross-sectional analysis on 10 812 subjects recruited within the cohort of the Moli-sani study (2005-2010). Psychological resilience was measured by the 25-item Connor-Davidson Psychological Resilience Scale. Food intake was recorded by the EPIC food frequency questionnaire and adherence to Mediterranean diet was appraised by both a Greek Mediterranean diet score and an Italian Mediterranean Index. Empirically derived dietary patterns were obtained by principal factor analysis. Multivariable linear regression analysis (95%CI) was used to test the association between dietary scores and psychological resilience.

RESULTS: Higher adherence to Mediterranean-type diets or consumption of a vegetable-based dietary pattern (obtained from principal factor analysis) were positively associated with psychological resilience (β=0.43; 95%CI: 0.19-0.66, β=0.92; 0.69-1.16, and β=1.18; 0.93-1.44, for Greek Mediterranean diet score, Italian Mediterranean Index and the ‘Olive oil and vegetables pattern’, respectively). Dietary polyphenol or antioxidant intakes and greater variety in fruit and vegetable consumption were also positively associated with psychological resilience, while the associations with Western-like diets were weak.

The Effects of Tai Chi on Lung Function, Exercise Capacity and Health Related Quality of Life for Patients With Chronic Obstructive Pulmonary Disease: A Pilot Study.

BACKGROUND: Although several studies have assessed the effect of Tai Chi in management of chronic obstructive pulmonary disease (COPD), these studies have a wide sample variation and convey inconclusive results. This study aims to determine if a 3-month Tai Chi program improves lung function, exercise capacity, and health related quality of life (HRQoL) in people with COPD.

METHODS: A randomised controlled, single blind trial was undertaken. Patients were randomly allocated to either Tai Chi group (n=26) or control group (n=24). Participants in the Tai Chi group received a Tai Chi exercise program three times weekly for 3-months while participants in the control group were advised to maintain their routine activities. Outcome measures included lung function, 6-minute walk distance (6WMD) and COPD Assessment Test (CAT). The measurements took place at baseline and immediately after the 3-month intervention period.

INTERVENTIONS: Patients were randomly allocated into either an intervention group or a control group. The intervention group (n = 25) received TCQ training under physiotherapist supervision for 1 h, three times per week, for 12 weeks and a home exercise program was provided for another 2 days. The control group (n = 25) received only a home exercise program for 12 weeks, 5 days per week.

OUTCOME MEASURES: All patients were assessed before and after the exercise program. Objective parameters of sleep were measured by polysomnography, while subjective parameters of sleep were assessed using the Epworth Sleepiness Scale (ESS) and the 3-factor Pittsburgh Sleep Quality Index (PSQI). Pulmonary functions were assessed with a pulmonary function test; health-related quality of life was evaluated through the Short Form-36.

RESULTS: In the intervention group, there was a statistically significant decrease in the apnea-hypopnea index (AHI) (p = 0.001) and percentage and duration of stage N2 sleep (p = 0.041 and p = 0.037, respectively), while there was a statistically significant increase in percentage and duration of stage N3 sleep when compared with the controls (p = 0.048 and p = 0.043, respectively). There was a statistically significant decrease in the ESS, PSQI sleep efficiency, and total scores (p = 0.001, p = 0.003, and p = 0.003, respectively).

The effects of alcoholic extract of saffron (Crocus satious L.) on mild to moderate comorbid depression-anxiety, sleep quality, and life satisfaction in type 2 diabetes mellitus: A double-blind, randomized and placebo-controlled clinical trial.

OBJECTIVE: Depression and anxiety are major health problems throughout the world. Metabolic changes in type 2 diabetes mellitus induces and aggravates mental disorders, such as depression and anxiety. Saffron as a therapeutic herb may attenuate Comorbid Depression- Anxiety (CDA). So, this trial is designed to investigate the effect of saffron alcoholic extract on symptoms of CDA in type 2 diabetic patients.

METHODS: Fifty-four outpatients suffered from mild to moderate CDA diagnosed by using Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), were assessed by Hamilton Depression and anxiety measurements, the Pittsburgh Sleep Quality Index (PSQI), and the Satisfaction with Life Scale (SWLS). The participants of this double-blind, placebo-controlled, single center and randomized trial were randomly assigned to intake 30 mg/day saffron or placebo capsules for 8 weeks.

RESULTS: After the intervention, mild to moderate CDA, anxiety and sleep disturbance, but not depression alone, were relieved significantly in the saffron group (P < 0.05), whereas, the changes were not significant in the placebo group. Anthropometric measures and blood pressure parameters of the patients in either groups did not change significantly (P > 0.05) during the intervention. Moreover, dietary intake and physical activity did not differ during the study in the two groups. Changes in the life satisfaction were not significant.

CONCLUSION: The results indicate the beneficial effect of saffron on the mild to moderate CDA in type 2 diabetic patients.

Exercise may be beneficial to older persons living with peripheral neuropathy (PN), but maintaining an exercise program is challenging. After participating in a 12-week tai chi (TC) study, 12 participants requested classes continue. A mixed-methods design was used to explore long-term engagement of older persons with bilateral PN enrolled in a TC class for 18 months beyond the original 3-month study. Pre- and posttest measures of functional status and quality of life (QOL) were conducted. Focus groups were held after 18 months of twice-weekly classes. Psychosocial support was critical to participants’ long-term commitment to exercise. Participants reported, and objective assessments confirmed, increased strength, balance, and stamina beyond that experienced in the original 12-week study. Changes in QOL scores were nonsignificant; however, qualitative data supported clinical significance across QOL domains. Results from this study support psychosocial and physical benefits of TC to older persons.

Be well!

JP

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